Opioid-Prescribing Continuity and Risky Opioid Prescriptions

Area of Science:

• Public Health
• Pharmacology
• Health Services Research

Background:

• Opioid prescribing continuity is poorly understood in relation to overdose risk.
• Risky prescribing patterns contribute to significant opioid-related harms.
• Effective strategies are needed to mitigate opioid-related morbidity and mortality.

Purpose of the Study:

• To investigate the association between opioid prescribing continuity and overdose risk.
• To examine the relationship between prescribing continuity and risky opioid prescribing.
• To determine if continuity of care can be measured using administrative pharmacy data.

Main Methods:

• Retrospective cohort study using Oregon's Prescription Drug Monitoring Program (PDMP), vital records, and hospital discharge data.
• Inclusion of patients with long-term opioid use.
• Calculation of a continuity of care index (COCI) score and definition of metrics for risky prescribing and overdose.

Main Results:

• Higher prescribing continuity (COCI score) was associated with a decreased likelihood of filling risky opioid prescriptions.
• Increased prescribing continuity correlated with a reduced likelihood of overdose hospitalization.
• Administrative pharmacy data can be utilized to calculate prescribing continuity.

Conclusions:

• Opioid prescribing continuity is a significant factor in mitigating opioid-related harms.
• Enhancing prescribing continuity may be a viable strategy to reduce overdose risk.
• The COCI score offers a quantifiable measure of prescribing continuity for public health surveillance.